Dental implants are commonly used as anchoring members in prosthodontics restorations to provide prosthetic teeth at one or more edentulous sites in a patient's dentition at which the patient's original natural teeth have been lost or damaged. Implant systems can include a dental implant made from a suitable biocompatible material, such as titanium. The dental implant can be threaded into a bore, which is drilled into the patient's mandible or maxilla at the edentulous site. The dental implant provides an anchoring member for a dental abutment, which is typically also made from a biocompatible metal such as titanium or ceramic. The dental abutment in turn provides an interface between the implant and a dental restoration. The dental restoration is typically a porcelain crown fashioned to replicate the shape of the tooth being replaced.
Many dental implant surgeries are performed in two stages. In the initial or first stage, an incision is made in the patient's gingiva at an edentulous site, and a bore is drilled into the patient's mandible or maxilla at the edentulous site, followed by threading or impacting a dental implant into the bore using a suitable driver. Thereafter, a cap is fitted onto the implant to close the abutment coupling structure of the implant, and the gingiva is sutured over the implant. Over a period of several months, the patient's jaw bone grows around the implant to securely anchor the implant in the surrounding bone, a process known as osseointegration.
In a second stage of the procedure following osseointegration, the dentist reopens the gingiva at the implant site and secures an abutment and optionally, a temporary prosthesis or temporary healing member, to the implant. Then, a suitable permanent prosthesis or crown is fashioned, such as from one or more impressions taken of the abutment and the surrounding gingival tissue and dentition. In this final stage, the temporary prosthesis or healing member is removed and replaced with the permanent prosthesis, which is attached to the abutment with cement or with a fastener, for example. Alternative single stage implants with integral emergence profiles or one-piece implants with integral abutments can be used, and can extend through the transgingival layer so that the gingiva need not be reopened to access the implant. If the patient has more than one tooth missing, multiple implants can be used to provide anchorage for a denture bar, a bridge, or other prosthodontic appliance.
To drill holes in the jawbone of a patient, an oral surgeon can use a drill guide, which is typically formed as a custom patient-specific appliance that overlays the drill site and at least a portion of the surrounding gum tissue and/or dentition. The drill guide includes a hole aligned along the intended drill axis, and one or more removable drill guide tubes can be positioned within the drill guide hole to allow drills of different diameters to be used in succession for drilling the holes in the jawbone in which the dental implants will be secured.